Making the Cut: Forget boob jobs and Botox. These days, the pressure to be perfect is hitting many w

Like many women in their mid-20s, Linda was unhappy about a certain part of her body. It wasn’t small breasts, saggy thighs or acne-covered skin — the usual things women are made to worry about — rather, she was bothered by something most folks don’t see: her labia. Linda’s labia minora (the small flaps of skin on either side of the vaginal opening, inside the labia majora, the outside lips with hair on them) had always bothered her. “It was physically uncomfortable, and I didn’t find it very aesthetically pleasing,” she says.

Her labia minora were long and protruded out of her labia majora. They rubbed against her clothing and made bike riding uncomfortable. But mostly, she didn’t like the way they looked. So Linda did what more and more women with long labia minora are doing: she went to a plastic surgeon and had them trimmed with lasers and scalpels for $4,500.

Many plastic surgeons around the world will perform labiaplasty (surgery on the labia minora) to create what some call a designer vagina. This is just one of a number of cosmetic surgeries women can get between our legs. Options include having electrolysis to remove pubic hair (for that hairless, prepubescent look), having the vagina tightened (after childbirth), having the hymen “repaired,” and now, if inside lips stick out of outside lips (which is common), labia can be “beautified” by making the lips smaller.

Toronto plastic surgeon Robert Stubbs, who performed Linda’s labiaplasty, has done more than 205 labia minora shortenings, on women aged 14 to 60. His signature procedure — trimming the hood of the clitoris as well as the lips — has been nicknamed the “Toronto trim.” Very few of these trims have been done on women who experienced pain from their labia. “The majority are cosmetic,” Stubbs says. “Women don’t want to compete with men with something large between their legs; they want something small, neat and tidy and tucked up out of the way.”

There are many reasons why a woman might consider having genital surgery. Gynecologists have started using techniques borrowed from plastic surgery to perform sex-change operations, repair ripped and torn vaginas after childbirth and rape, and improve the sexual and physical health of many women. Ultimately, it’s the individual woman’s decision to make.

What’s worrying is that most women who have labiaplasties do so for purely aesthetic reasons. While exact numbers are unavailable, it’s estimated that thousands of women have paid thousands of dollars and risked painful side effects to have the most sensitive part of their bodies cut up.

Many women who have publicly spoken about their labiaplasties use the same language as Stubbs. Take Patricia, a 32-year-old mother of two from New York City who had her labia shortened: “It was all hanging so he fixed all that, and it’s nice and it’s neat now.”

Bernard Stern, the Florida doctor who performed Patricia’s labiaplasty, says he’s operated on all kinds of women, including “Las Vegas showgirls, exotic dancers, a Playmate of the Year from Playboy, tons of doctors, nurses, midwives, attorneys, an attorney general for one of the municipalities here in Florida … professional athletes … triathletes, marathoners, junior Olympians, equestrians, Pilates instructors and personal trainers.” The oldest woman he’s operated on was 82, the youngest 16. He once did a 19-year-old and then her 40-year-old mother six months later. He argues that although only a minority of his patients experienced physical discomfort from their labia, some experience emotional stress: “Quite honestly, most of the people that come in here have stuff that’s just unbelievable, there’s no doubt, I mean [the labia are] totally uneven, one side’s huge, the other’s not … for some of them, this is a life-changing procedure.”

Of course, his opinion may have something to do with the big money involved. A labiaplasty surgeon can easily gross up to $250,000 U.S. a month. Ask people with nothing to gain from the procedure — health professionals and sex experts, for example — and you get a different story. With surgery comes risk: labiaplasty can have side effects such as nerve damage, scarring, vaginal soreness and hemorrhaging. One gynecologist reports women losing sensitivity after surgery and experiencing pain during sex. The nerve networks of the female genitalia haven’t yet been accurately mapped. Cutting the lips could remove important and pleasurable nerve endings and replace them with numb scar tissue.

And doctors don’t agree on what degree of surgery is appropriate. Stubbs has removed the hoods from many women’s clitorises to make it easier for a penis to rub the clitoris during intercourse. But that hood exists to protect the sensitive clitoris when a woman isn’t having sex and Stern is against removing it: “The outcomes of clitoral surgery are so variable, much more painful because of all the nerve endings around it, and I’ve seen horrible scarring from other people’s [unhooding] surgery.”

Simone Davis, a professor and gender theorist at Mount Holyoke College in Massachusetts, fears that labiaplasty makes all women look pretty much the same between our legs, even though we are born looking very different. Surgeons perpetuate the idea that there is a right and a wrong way for a woman to look, and the right way is to have a “clean slit,” says Davis. “There’s a trend in the U.S. to wipe away all blemishes, and we do it with makeup, we do it with plastic surgery ? Labia are neither inside nor outside, they are gateway tissues, and they kind of represent a part that is confusing.”

Davis points out that before the rise of pornography, most people were not exposed to images of female genitals. Most heterosexual women have only seen their own vaginas and picture-perfect porn images, making it easy to prey upon their insecurities and doubts.

Although cosmetic labiaplasty is a new trend, people have been cutting up women’s vulvas for centuries in various regions of the world. In many parts of Africa and the Middle East, girls routinely undergo clitoridectomies (have their clitorises cut off) as part of coming-of-age rituals. In the most extreme version of female circumcision, as it’s often called — or female genital mutilation (FGM), as the Canadian court system refers to it — the entire clitoris and all of the labia minora are cut off, and the vaginal opening is sewn partially together. The idea is that if a woman experiences pain rather than pleasure during sex, she will stay faithful to her husband.

Although FGM is illegal in both the U.S. and Canada, Davis says, “when you really look carefully at the language used in some of those laws, they would also make illegal the labiaplasties that are being done by plastic surgeons in the U.S.”

Europe and North America have a long history of women’s clitorises being removed. For example, a 19th-century English doctor performed a number of clitoridectomies to reduce “hysteria” and to combat “excessive” masturbation. He was criticized in England, but some American doctors enthusiastically began to slice women’s reproductive organs to try to “correct” female behaviour. They would remove the hood or the ovaries to “elevate the moral sense of the person.” The practice continued into the 20th century, often as a supposed cure for marital unhappiness.

In 1959, a doctor named W.G. Rathmann published an article in a respected scientific journal about a clamp he’d created to cut the hood off in one clean stroke. Rathmann felt that if a woman climaxed more easily, she and her male partner would be happier. One of his patients, he claims, had divorced four times before seeing him, and supposedly said she had “wasted four perfectly good husbands” by not having surgery sooner. This may sound old-fashioned, but modern-day doctor Stern also claims that for many, a labiaplasty or vaginal tightening can “save their marriage.”

Rathmann presented his ideas as though he was motivated by compassion for women. However, like many of his medical peers, he thought female genital surgery was the solution to not only sexual frustration and female insecurity, but also male ignorance and stupidity: “If the husband is unusually awkward or difficult to educate, one should at times make the clitoris easier to find.”

In the ’70s and ’80s, Ohio gynecologist James Burt performed more than 4,500 of his own “surgeries of love” — most without consent. While women were on his operating table for other problems, such as incontinence, he would reposition their vaginas to a different angle and trim their clitoral hoods. He felt God had improperly designed a woman’s insides to suit a man’s pleasure, and saw himself as correcting the mistake.

Burt eventually lost his license. His patients wound up with horrendous infections, pain during sex, chronic bowel and urinary problems, loss of sexual sensation — and $20 million from the Ohio Supreme Court.

Today, for a mere $3,500 to $7,000, women are beating a path to the plastic surgeon’s door. “People say that what is so awful about [African] ritual cutting is that they do it without consent,” says Davis, “but in the west, we do consent, and we even pay for the privilege!”

Is smaller really better? I pondered this one evening at the bar where I work, leafing through some plastic surgery material. Peaches, a muscular security guard covered in tattoos, looked over my shoulder at the photos.

“Is she getting her labia minora reduced?” he asked. “No way, man, she should be making them longer!” he added, and made some crude gestures to illustrate how much he liked oral sex with long lips. “It’s just sexy. See that?” he pointed to a woman with very long labia minora. “That is absolutely beautiful. The lips, for me, are a huge turn on.”

Many men feel the same way. After sex columnist Dan Savage advised a woman to go to Stubbs for her long lips, hundreds of male readers replied.

“I prefer long labia,” wrote one reader. “I find they lend themselves more readily to being tugged, stretched, nibbled, etc.” Another told Savage: “You were much too hasty to recommend clipping her butterfly wings!”

Many cultures have taken labia love to the next level and actively massaged and stretched a girl’s labia from childhood on to make them as long as possible (most notably the Buganda people of Uganda). Labiastretching.com celebrates long labia in much the same way body modification enthusiasts have adopted the ear plugs of some African cultures to stretch their earlobes. The site features a photo gallery, advice on lengthening and erotic stories. And girls, if your labia are 10 centimetres or longer, you can enter a contest to win the title of the world’s longest labia.

I’m not about to stretch my labia down to my knees. Some photos on the site made me wince just thinking about tight pants. But I was delighted to see that at least some people don’t think my curtains need to be hemmed.

When I was 13, I didn’t like my labia. I remember sitting on my bed, looking at illustrations of women’s labia in a late edition of the Kinsey Report. I thought the long, foldy labia looked kind of strange compared to the nice, neat, miniscule labia minora that some women had. Suspicious, I grabbed a mirror and looked down. I was saddened to find that mine were more like the foldy ones.

For years, I was insecure. I was scared of what sex would be like and didn’t think young men (or women) thought of the space between a girl’s legs as pretty. Functional and pleasurable, maybe, but not nice to look at. And with foldy labia, how would I compare to the girls with neat, “clean slits”?

Like other insecurities, this one disappeared eventually. None of the men I have been with cared what my labia looked like. What’s more, the lips are meant to give you pleasure. They’re full of nerve endings and swell with blood during sex to give you extra sensation. Had I trimmed myself when I was a teenager, I would have missed out on a lot of fun.

So when I started perusing websites for this article, I was angered to find myself feeling like a scared 13-year-old again. Surgeons will tell you otherwise, but this industry thrives on female insecurity and often tries to convince us to fork over $5,000 or more to feel better about ourselves. Many of the websites use language aimed at undermining female confidence, particularly when it comes to what men think about our genitals.

“Due to childbirth and aging the vagina can become stretched,” states www.lipoman.com. “The loose feeling many women feel is noticed even more by their male partner during sexual intercourse … [and] commonly the unsightly appearance of the excess skin [of large labia] causes psychological damage that results in the loss of sexual desire for both partners.”

Davis visited an L.A. labiaplasty surgeon under the guise of wanting information: “He tried to convince me that to do the operation would not be being a woman hating herself, but [that] I was going to be liberating myself. He took the feminist language of choice, and he was giving it back to me as though I had the right to choose what kind of vagina I wanted.”

Look through plastic surgery literature and you will easily be able to find a few problems with yourself that a little laser could fix. I discovered that I’m a perfect candidate for breast implants, labia shortening and clitoral unhooding, which is deemed necessary by some doctors for women who usually only reach orgasm from direct clitoral stimulation instead of intercourse alone. Research has shown that three-quarters of all women need fingers, tongues or vibrators to reach orgasm. So in the eyes of some surgeons, the vast majority of us could use a little fixing.

“Plastic surgeons from the very beginning have employed medical language to make people feel uncomfortable about the shapes of their bodies,” says Davis. “In the ’50s, when they started doing breast implants, they would use terminology like ‘micromastia,’ meaning ‘flat-chestedness.’ Suddenly it becomes like a disease to have small breasts.” A similar language of disease — with words like “deformity” and “excess tissue” — is now used to sell genital cosmetic surgery.

I, for one, am not stuffing silicone in my breasts. I don’t believe it’s a feminist act, as some have described it, to surgically alter my body. I don’t have to go Brazilian to be sexy. And I’m not changing a thing about my labia — if you don’t like them, go find another pair.